本文選題：Ilizarov　切入點(diǎn)：下肢感染性骨缺損　出處：《中國老年學(xué)雜志》2017年21期 　論文類型：期刊論文

【摘要】：目的探討中西醫(yī)結(jié)合改良Ilizarov術(shù)對(duì)下肢感染性骨缺損(LEIBD)和肢體短縮的臨床療效。方法 40例LEIBD患者按照不同療法分為兩組,采用西藥結(jié)合改良Ilizarov術(shù)為對(duì)照組18例,在對(duì)照組的基礎(chǔ)上輔助中醫(yī)治療患者22例為中藥組。分析兩組療法對(duì)骨缺損和肢體短縮的臨床療效。結(jié)果經(jīng)過4~6 w抗感染治療,隨訪6~18個(gè)月,患者炎癥都治愈。10例股骨患者在術(shù)后9例兩下肢均衡發(fā)展等長(zhǎng),可負(fù)重行走。30例脛骨患者28例兩下肢等長(zhǎng),兩下肢短縮0.5 cm,較滿意。中藥組治療率高于對(duì)照組,但差異無統(tǒng)計(jì)學(xué)意義(P0.05),愈合期顯著低于對(duì)照組(P0.05),同時(shí)手術(shù)次數(shù)也相對(duì)較少。9例股骨患者在術(shù)后髖關(guān)節(jié)功能均正常,7例表現(xiàn)僵硬,3例可以屈伸,其中中藥組正常率高于對(duì)照組,但差異無統(tǒng)計(jì)學(xué)意義(P0.05);30例脛骨患者28例膝關(guān)節(jié)功能正常,2例輕度屈伸受限,其中中藥組正常率高于對(duì)照組(P0.05);3例踝關(guān)節(jié)融合,15例踝關(guān)節(jié)功能正常,1例部分屈伸障礙,其中中藥組正常率高于對(duì)照組,但差異無統(tǒng)計(jì)學(xué)意義(P0.05)。中藥組釘眼異常、軸向偏移、多發(fā)性關(guān)節(jié)攣縮癥及松動(dòng)均低于對(duì)照組,并發(fā)癥率低。結(jié)論采用中西醫(yī)結(jié)合改良Ilizarov術(shù)對(duì)LEIBD和肢體短縮的臨床療效突出,骨愈合率高,并發(fā)癥少。
[Abstract]:Objective to investigate the clinical effect of modified Ilizarov in the treatment of infective bone defect of lower extremity and limb shortening. Methods 40 patients with LEIBD were divided into two groups according to different treatments, and 18 patients were treated with western medicine combined with modified Ilizarov as control group. On the basis of the control group, 22 patients were treated with traditional Chinese medicine (TCM). The clinical efficacy of the two groups in the treatment of bone defect and limb shortening was analyzed. Results after 4 weeks of anti-infection therapy, the patients were followed up for 6 ~ 18 months. Inflammation was cured in all the 10 cases of femur. After operation, 9 cases of femur developed equably long, 28 cases of tibia could walk with weight bearing, 28 cases had equal length of lower extremity and 0.5 cm of shortening of lower extremities, the treatment rate of Chinese herbal medicine group was higher than that of control group, and the treatment rate of Chinese medicine group was higher than that of control group. However, the difference was not statistically significant (P 0.05), and the healing period was significantly lower than that in the control group (P 0.05). At the same time, the number of times of operation was also relatively small in 7 cases with normal hip joint function and 7 cases with stiffness after operation. The normal rate in the Chinese medicine group was higher than that in the control group. However, there was no significant difference between 30 patients with tibia and 28 patients with normal knee joint function and 2 patients with mild flexion and extension limitation. The normal rate in the Chinese medicine group was higher than that in the control group (P 0.05), 3 cases of ankle fusion and 15 cases of ankle joint function were normal and 1 case had partial flexion and extension disorder. The normal rate of TCM group was higher than that of control group, but the difference was not statistically significant (P 0.05). The nail-eye abnormality, axial deviation, multiple joint contracture and loosening in TCM group were lower than those in control group. Conclusion modified Ilizarov combined with traditional Chinese and Western medicine is effective in the treatment of LEIBD and limb shortening. The rate of bone healing is high and the complications are less.
【作者單位】： 武漢市第三醫(yī)院骨科;
【基金】：武漢市衛(wèi)生局科研項(xiàng)目(No.WX11C15)
【分類號(hào)】：R687.3

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